Nutritional Pathology Topics Nutritional ... - มหาวิทยาลัยนเรศวร

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9/7/2012Secondary PEM.SyndromeClinicalsettingTimecourseClinical featuresLaboratoryfindingsPrognosis1. marasmuslikePEMChronicillness (e.g.,chronic lungdisease,cancer)MonthsHistory of weightloss, musclewasting, absentsubcutaneous fat“Cachexia”Normal ormildlyreducedserumproteinsVariable;dependsonunderlyingdiseaseKwashiorkor2. kwashiorkorlikePEMAcute,catabolicillness (e.g.,severetrauma,burn, sepsis)WeeksNormal fat andmuscle , edema,easily pluckablehairSerumalbumin 2.8 gm/dlpoor<strong>Topics</strong>• <strong>Nutritional</strong> deficiencies– Protein – Energy Malnutrition– Anorexia Nervosa and Bulimia– Vitamin Deficiencies– Mineral Deficiencies• Obesity• Diet and Systemic DiseasesAnorexia Nervosa• Self-induced starvation, resulting in markedweight loss• Manifested as severe PEM with endocrineabnormalities– Amenorrhea (GnRH, LH, FSH)– Decreased bone density (low estrogen level)– Decreased thyroid hormone release (coldintolerance, bradycardia, constipation)• Increased susceptibility to cardiacarrhythmia and sudden death4
9/7/2012http://www.funatiq.com/images/anorexia-nervosa-model.jpgAnorexia Nervosahttp://www.womenshealthzone.net/eating-disorders/anorexia-nervosa/effects/img/1287.gifhttp://1.bp.blogspot.com/_cBDzDLF1zns/SE_ELpvdbjI/AAAAAAAAACk/92KsZWfMR8M/S740/normal_00031778.jpgBulimia• A condition in which the patient binges onfood and then induces vomiting• Amenorrhea occurs in less than 50% of Pt.,Wt. and gonadotropin levels are near normal• Major medical complications:– Electrolyte imbalances (Hypokalemia) and cardiacarrhythmia– Pulmonary aspiration of gastric content– Esophageal and cardiac rupturehttp://www.netscool.com/elrio/daniela/bulimia.jpg5
Page 2 and 3: 9/7/2012ภาวะทุพโภ
Page 6 and 7: 9/7/2012TopicsBulimia• Nutritiona
Page 8 and 9: 9/7/2012RicketsVitamin DDeficiency
Page 10 and 11: 9/7/2012Pectus excavatum (Funnel ch
Page 12 and 13: 9/7/2012Cause of deficiency :-fat m
Page 14 and 15: 9/7/2012Vitamin B3 (Niacin)- an ess
Page 16 and 17: 9/7/2012Vitamin C (Ascorbic acid)-F
Page 18 and 19: 9/7/2012Koilonychiahttp://www.topne
Page 20 and 21: 9/7/2012Topics??• Nutritional def
Page 22 and 23: 9/7/2012Exercise more than 3 times

Nutritional Pathology Topics Nutritional ... - มหาวิทยาลัยนเรศวร

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